WiAHC Legislative Outreach Program

Grassroots advocacy is the most powerful tool WiAHC has at its disposal to shape public policy – and building relationships with lawmakers is the most important aspect of grassroots advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has established our Coffee Conversations with Legislators advocacy program.

The initiative is designed  to help connect members with their local legislators. Under the program, the WiAHC Government Affairs Team will set-up in-district meetings between WiAHC members and state lawmakers who represent them in the Legislature. These meetings, which can be located at your facility, or a local coffee shop provide a tremendous opportunity for WiAHC members to build or strengthen their relationships with local legislators and to educate them on home health care and on policy issues important to home health care professionals and their patients.

Again, WiAHC encourages all members to participate in this critical grassroots advocacy program. If you’re interested in participating, please contact the WiAHC office at wiahc@badgerbay.co.

WiAHC is happy to remind members about and provide links to the latest articles and information on the home health care industry from Home Health Care News and other publications:

·         Home Care Providers Keep Cautious Eye On Medicare Advantage: NAHC President

Home Health Care News - By Patrick Filbin | January 19, 2023

Home health providers should keep a close eye on the rise and popularity of managed care plans under Medicare Advantage in 2023. That was one of the many messages from Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), during Wednesday’s webinar with Netsmart. Read more…

·         The Potentially Dire Long-Term Impact Of Home Health Agency Closures

Home Health Care News - By Patrick Filbin | January 17 2022

Back in October, Hospice and Home Care of Juneau closed after 20 years in business. A month earlier, Trinity Health At Home in Springfield, Illinois, shut its doors and laid off 60 employees. At the start of the new year, Oahu Home Healthcare announced it was shutting down, leaving just eight at-home care agencies on the most populated island in Hawaii. Read more…

·         MedPAC Unanimously Recommends Home Health Payment Rate Cuts

Home Health Care News - By Patrick Filbin | January 12, 2023

In a unanimous vote Thursday, the Medicare Payment Advisory Commission (MedPAC) recommended that the Medicare base payment rate for home health care be reduced by 7% for CY 2024.

This recommendation is in line with previous recommendations by the commission over the years. Read More…

 

·         Top Home Health Trends For 2023

Home Health Care News - By Andrew Dolan | January 6, 2023

Home health care’s 2022 was dimmed by the dark cloud of Medicare rate cuts. That cloud still hangs overhead in 2023. To weather the storm, providers are scrambling to find answers to persistent problems, namely staffing shortages. At the same time, they’re renegotiating arrangements with Medicare Advantage (MA) plans and pivoting from certain service lines to others. They’re attempting to become more efficient – in any way possible. Read more…

·         FTC Proposes Rule that Would Ban Employee Noncompete Clauses

Associated Press – Alexandra Olson and Michelle Chapman| January 6, 2023

The Federal Trade Commission proposed a rule Thursday that would ban U.S. employers from imposing noncompete clauses on workers, a sweeping measure that could make it easier for people to switch jobs and deepen competition for labor across a wide range of industries. The proposed rule would prevent employers from imposing contract clauses that prohibit their employees from joining a competitor, typically for a period of time, after they leave the company. Read more…

Home Health Care News, which is part of the Aging Media Network, is a leading source for news and information covering the home health industry.

Several important updates and policy changes are included in the 4,100 page Omnibus bill released at the end of 2022. National Association for Home Care & Hospice (NAHC) has distilled those provisions that directly or indirectly affect home care and hospice. Those include both policy changes and funding actions through federal appropriations. NAHC will continue to keep the community aware of and understanding the implications of this end-of-the-year legislation. More information available on the NAHC website.  Additional links:

·           Bill Text

·           Explanation of Senate Finance Committee

·           Summary of LHHS Bills

·           Explanatory Statement of Health-Related Bills

WiAHC Legislative Outreach Program

Grassroots advocacy is the most powerful tool WiAHC has at its disposal to shape public policy – and building relationships with lawmakers is the most important aspect of grassroots advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has established our Coffee Conversations with Legislators advocacy program.

The initiative is designed  to help connect members with their local legislators. Under the program, the WiAHC Government Affairs Team will set-up in-district meetings between WiAHC members and state lawmakers who represent them in the Legislature. These meetings, which can be located at your facility, or a local coffee shop provide a tremendous opportunity for WiAHC members to build or strengthen their relationships with local legislators and to educate them on home health care and on policy issues important to home health care professionals and their patients.

On December 6, WiAHC Board Chair Jayne Thill is hosting State Representative Jesse James (R-Altoona) at the Compassus office in Marshfield, WI. Rep. James was elected to the state Senate on Nov. 8 and will be sworn in next year as the new senator from Wisconsin’s 23^rd Senate District, which covers Chippewa County, as well as portions of Eau Claire, Dunn, Clark, Wood, and Marathon Counties. The meeting will provide a great opportunity for Jayne and WiAHC to establish a strong working relationship with a newly elected senator. However, this meeting alone is not going to raise WiAHC’s profile in the State Capitol. We need numerous members from many communities across the state to host a legislative visit. It’s key to our advocacy success…

Again, WiAHC encourages all members to participate in this critical grassroots advocacy program. If you’re interested in participating, please contact the WiAHC office at wiahc@badgerbay.co.

WiAHC Legislative Key Contact Program

If you were not yet aware, we would like to remined you about WiAHC’s Legislative Key Contact Program, which can be a highly effective grassroots advocacy tool to help build and nurture strong on-going relationships between WiAHC members and lawmakers in Wisconsin. Ultimately, the program can help us help shape new policies important to our members.

The program is now live on the WiAHC website and members can easily and quickly sign-up as a Key Contact. With the campaign season winding down, and the 2023-24 legislative session right around the corner, it’s more important than ever for WiAHC to have a robust Key Contact Program. It is essential to raising our profile in the State Capitol and beyond.

As a Key Contact, you can help influence the legislative process by cultivating relationships with elected officials. By taking advantage of existing relationships and making new contact with members of the Wisconsin Legislature (as well as the Wisconsin Congressional  Delegation), you can help us educate lawmakers on industry issues and influence legislation.

But the program will not succeed without strong member participation, so please take a few moments to read more about it – and learn how simple it is to “enlist” and participate as a Key Contact. The time commitment is minimal and your responsibility as a key contact depends on your level of comfort and willingness to engage.

Remember, lawmakers are often eager to hear input from their constituents, and as an expert in the home health care field, you can make a real difference in the policy process as a Key Contact. CLICK HERE to sign-up by filling out and submitting a brief online survey.

WISCNEWS – Oct. 27, 2022

The Wisconsin Association for Home Health Care presented Sen. Joan Ballweg (R-Markesan) with the organization’s 2022 Champion of Home Health Care legislative award for her leadership on policies to advance home health care in Wisconsin and improve the delivery of patient care provided by home health professionals, according to an Oct. 25 press release. Read more…

WiAHC is happy to remind members about and provide links to the latest articles and information on the home health care industry from Home Health Care News and other publications:

·         22 States Petition For CMS To Repeal Vaccine Mandate For Health Care Workers

Home Health Care News - By Joyce Famakinwa | November 18, 2022

A group of 22 states — led by Montana Attorney General Austin Knudsen — have urged the Centers for Medicare & Medicaid Services (CMS) to lift the COVID-19 vaccine mandate for health care workers in the Medicare and Medicaid space. The 22 states include Montana, Louisiana, Tennessee, Arizona, Alabama, Alaska, Arkansas, Florida, Indiana, Kansas, Kentucky, Mississippi, Missouri, Nebraska, New Hampshire, Ohio, Oklahoma, South Carolina, Texas, Utah, Virginia and Wyoming. Read More…

·         Home Care Provider Leaders Get Candid About Survival Amid Rising Costs

Home Health Care News - By Patrick Filbin | November 18, 2022

While the tailwinds in the market remain, personal home care provider leaders have a lot more to consider about their futures than they did just five years ago. Their thought processes are still resetting. And as they do, their organizations’ strategies will reflect that. Read more…

·         DOL Recovers $28 Million In Back Wages For Home Health Workers, Others

Home Health Care News - By Patrick Filbin | November 16, 2022

The U.S. Department of Labor announced this week that it has recovered more than $28 million in back wages and damages for nearly 25,000 workers in the home health, skilled nursing facility (SNF) and residential care settings. Specifically, the DOL reported that it had recovered $1.2 million in back wages for 600 home health care workers in Texas and Louisiana. Read more…

·         Final home health rule gives industry a fright

McKnights Health Care – By Liza Berger | November 4, 2022

Just in time for Halloween, the federal government released a final home health rule. While it may not have risen to the level of horror, it still managed to spook the industry.  In its final rule revealed Monday, the Centers for Medicare & Medicaid Services presented an expansion of Medicare payments for calendar year 2023 of 0.7%, or $125 million, compared to 2022. This figure reflects a 4% market-basket update, or $725 million; a behavioral adjustment of -3.925%, a $635 million decrease; and a small uptick of 0.2%, or $35 million increase. Read more…

·         In Case You Missed It: CMS Backs Off Severe Cuts, Finalizes 0.7% Increase To 2023 Provider Payments

Home Health Care News - By Andrew Donlan | October 31, 2022

The U.S. Centers for Medicare & Medicaid Services (CMS) released its FY 2023 home health final payment rule late Monday. It comes with an estimated increase to 2023 home health payments of 0.7%, or $125 million, compared to 2022 aggregate payments. Although it sets up certain financial challenges moving forward, the final rule is better news for providers than what was previously expected. Read more…

Home Health Care News, which is part of the Aging Media Network, is a leading source for news and information covering the home health industry.

A previous edition of the WiAHC Advocacy Newsletter reported the association’s 2023-24 Policy Agenda was pending final approval. We are now pleased to unveil the final document, which will be used to guide the association’s advocacy efforts over the next two years.

In addition to using member input to develop the association’s advocacy roadmap, the WiAHC Legislative Committee considered the following criteria when developing the Policy Agenda and individual issue priorities: 1.) The benefit to WiAHC members; 3.) The extent to which it will improve home health care in Wisconsin; and 3.) The likelihood of legislative/regulatory success.

The WiAHC Policy Agenda provides a broad policy vision for advancing home health care in Wisconsin and identifies the following specific legislative and regulatory goals for 2023-24:

• Regulatory reform legislation to modernize DHS 133, including provisions to better align Wisconsin home care regulations with federal home care regulations.

• Promote public awareness and increase policy influence of home health care, such as the creation of a Home Health Care Advisory Council at the Wisconsin Department of Health Services.

• Grow/strengthen Wisconsin’s home health care workforce: Secure additional state funding to support    increasing the supply of nurse educators in Wisconsin.
• Expand home health telehealth flexibility to leverage the effective delivery of virtual care, which ultimately benefits patients and helps to alleviate industry-wide workforce challenges.

CLICK HERE to review the full 2023-24 WiAHC Policy Agenda.

Although the home health care industry recently received a reprieve from drastic Medicare cuts, the financial threat to the industry is far from over.

In June 2022, CMS issued their proposed 2023 Home Health Payment Rule, which carried with it a proposed cut to Medicare payments of 4.2% , or $810 million. Fortunately, the final rule issued by CMS wasn’t quite as devastating, as it ultimately provided a Medicare payment increase of 0.7%, or $125 million, for 2023.

But as was mentioned above, we are still not out of the woods. The final rule also authorizes CMS to claw back, starting in 2024, $2.1 billion in what they say are overpayments from 2020 and 2021.

To maintain access to home health care services and prevent harm to the Medicare patients across Wisconsin that depend on essential health care provided in their homes, it’s critical to urge Congress to fix the potential chaos created by CMS by passing the Preserving Access to Home Health Act of 2022 (H.R. 8581 and S. 4605) before the end of the year.

The bipartisan bill would delay the 2023 payment cut and the $2 billion claw back efforts, allowing time for home health care to  negotiate with CMS on a better outcome. With that in mind, WiAHC would urge you to contact your Members of Congress TODAY and ask them to support this highly important legislative proposal. 

Of course, when advocating for home health with your Members of Congress, it is important to ensure your message is both compelling and clearly presented. Thankfully, our national partner, the National Association for Home Care and Hospice (NAHC), has made connecting with your elected representatives as easy as a few clicks on your computer or mobile device.

Simply CLICK HERE to contact your federal lawmakers on the Preserving Access to Home Health Act of 2022. All you need to do is fill in your name and contact information and hit SEND.

By Hoven Consulting  – WiAHC’s lobbying firm

·         November General Election Results – State Legislature

o   State Assembly: In the 2023-2024 legislative session, Republicans will have 64 members and the Democrats will have 35 members.  Republicans gained a net of four Assembly seats.  One of these Assembly seats is located in the western Milwaukee suburbs, two are located in far northwest Wisconsin, and the other is a district that is between Milwaukee and Madison and also includes the southcentral Wisconsin city of Milton.

o   State Senate: During the next legislative session, Republicans will have 22 members and the Democrats will have 11 members.  Senate Republicans gained one Senate seat that was held by Democrats.  This seat is located in far northwest Wisconsin and includes the community of Superior. 

·         Assembly and Senate Elect Leadership

On November 10, both the Senate and Assembly Republican caucuses met to elect their respective leadership teams for the 2023-2024 legislative session. 

Senate Republicans re-elected their current senior leadership team:

o   Senate President – Chris Kapenga (Delafield)

o   Senate President Pro-Tempore – Patrick Testin (Stevens Point)

o   Majority Leader – Devin LeMahieu (Oostburg)

o   Assistant Majority Leader – Dan Feyen (Fond du Lac)

The Assembly Republican caucus elected several members to new senior leadership roles.  The new senior leadership members are:

o   Assembly Speaker – Robin Vos (Rochester)

o   Assembly Speaker Pro Tempore – Kevin Petersen (Waupaca)

o   Majority Leader – Tyler August (Lake Geneva)

o   Assistant Majority Leader – Jon Plumer (Lodi)

During the week of November 14, both the Assembly and Senate Democratic caucuses elected their respective leadership teams for the 2023-2024 legislative session.  Senate Democrats also elected new members to their leadership team.  Their new senior leadership team is:

o   Minority Leader – Melissa Agard (Madison)

o   Assistant Minority Leader – Jeff Smith (Brunswick)

Assembly Democrats re-elected the following members to their current leadership roles:

o   Minority Leader – Greta Neubauer (Racine)

o   Assistant Minority Leader – Kalan Haywood (Milwaukee)

·         Occupational License Study Committee Update

On Tuesday, November 15, the Legislative Council Study Committee on Occupational Licenses held its November public meeting.  Included in the agenda for this hearing was testimony from a number of individuals, including representatives from the state Department of Safety and Professional Services (DSPS) – which processes most occupational credentials in the state – as well as discussion on several draft bills intended to improve the ongoing occupational credential processing backlog.  Most of the testimony from the DSPS representatives focused on this backlog. 

During the hearing, DSPS representatives repeatedly underscored their need for more staff – particularly call center staff and occupational credential processing staff.  They also discussed the need to offer higher salaries in order to attract and retain employees.  Committee chair/Senator Rob Stafsholt (R-New Richmond) indicated that he is open to possibly providing more funding in the 2023-2024 state budget to DSPS to hire more staff.  However, he underscored the committee’s prior request for more data on the processing backlog, which would help him justify that funding request.  DSPS representatives stated a few times during the hearing that they would need to re-task credential processing employees to gather that data, which would likely increase the backlog.  Chair Stafsholt stated that he realized that but obtaining that data would be critical to help to possibly secure additional staff funding for the agency.  Committee Vice Chair/Representative Shae Sortwell (R-Two Rivers) also appeared to be open to providing funding for additional agency staff but also agreed that DSPS needed to provide them with more data on the backlog first.

DSPS representatives appeared to be supportive of committee draft legislation increasing credential renewal periods from two years to four years, as well as legislation that removes the requirement for the agency to review certain types of minor criminal offenses.  However, they also noted that several of the committee’s other draft bills would require additional staffing to accomplish. 

After hearing all of the testimony, the committee was scheduled to have a discussion among themselves regarding their various draft bills addressing this processing backlog.  However, as the DSPS testimony and questioning ran much longer than anticipated, the committee agreed to adjourn and postpone discussion on these draft bills to their next public meeting, which is scheduled for December 13. 

NOTE:  If your hospice/palliative care agency has employees who are experiencing delays in receiving their occupational licenses, please contact WiHPCA’s government affairs professionals – either Nathan Butzlaff at (608) 310-8833 or nathan@hovenconsulting.com or Tim Hoven at (414) 305-2011 or tim@hovenconsulting.com. 

·         Uniform Death Reporting Standards Study Committee Update

The Legislative Council Study Committee on Uniform Death Reporting Standards held a meeting on October 17 in Madison.  Senator Joan Ballweg (R-Markesan) and Representative Jesse James (R-Altoona) serve as chair and vice chair, respectively, and heard various presentations, which are summarized below.   

Representatives from the state Department of Health Services (DHS) were the first to present at this hearing.  They discussed the National Violent Death Reporting System (NVDRS) and the State Unintentional Drug Overdose Reporting System (SUDORS).  In response to questions from committee members, DHS representatives noted:  (1) DHS requests NVDRS data from all counties, and most participate, though such participation is not required and (2) a significant majority of physicians continue to use a “fax attestation form” when certifying the cause and manner of natural deaths, rather than submitting that information as an electronic user of the State Vital Records Information System (SVRIS).

The second presentation featured representatives from the state Department of Justice.  Much of this presentation covered the types of death investigation training offered in Wisconsin.  In particular, they discussed: (1) the death investigation training provided at police academies, (2) an annual 80-hour course for death investigators organized by DOJ and (3) an annual four-day death investigation symposium organized by the Wisconsin Association of Homicide Investigators. 

Following the presentations, committee members discussed various issues.  Committee members expressed interest/support for the following:

o   Expanding the death record to include different data points, including noting whether substance abuse contributed to the death.

o   Requiring physicians to receive training on how to properly certify cause and manner of death, including training how to address the types of death that must be reported to coroners or medical examiners.

o   Requiring all those who certify deaths (e.g., physicians) to submit the medical certification electronically using the State Vital Records Information System (SVRIS).

o   Creating a state statute governing fatality review teams in a manner codifying current practice (allowing counties to decide which types of teams, if any, are created).

·         Hard Launch of Electronic Visit Verification for Personal Care Services and Supportive Home Care Services

In November, the DHS announced that as of May 1, 2023, the agency will begin imposing penalties when personal care and home health care agencies do not collect the required electronic visit verification (EVV) for Medicaid-covered personal care and supportive home care services.  The included service codes are:  T1019, T1020, S5125 and S5126. 

For more information, please contact DHS at 1-833-931-2035 or VDXC.ContactEVV@wisconsin.gov.

• ·         DHS Medicaid Home and Community-Based Service Grant Program

On November 3, DHS awarded $12 million to over 40 organizations that provide home and community-based services to senior citizens or disabled individuals.  The intent is to support the direct care workforce in this field.  These grant funds are sourced from federal American Rescue Plan Act (ARPA) allocation of dollars to Wisconsin. 

DHS intends to open a second round of grants in February 2023.  According to the DHS website, applicants can be: 

o   A provider whose work supports HCBS participants

o   An MCO active with HCBS programs in Wisconsin

o   An IRIS consultant agency

o   A university whose work supports HCBS providers or participants

o   An advocacy agency whose work supports HCBS participants

o   An association whose membership comprises HCBS providers

o   A local government agency whose work supports HCBS providers or participants

Also, the DHS website states that grant funds must benefit at least one of the following:

o   Individuals receiving HCBS

o   Families of individuals receiving HCBS

o   HCBS providers

o   Direct care workers of HCBS providers

For more information, go to the HCBS grants page on the DHS website.

Last week, US Department of Health & Human Services (HHS) Secretary Xavier Becerra announced the renewal of the public health emergency (PHE) due to the ongoing COVID-19 pandemic. The PHE was originally declared on January 31, 2020 and has been renewed continuously since then. Renewal of the PHE keeps a number of important waivers and flexibilities active. The current PHE declaration will last 90 days from its effective date of October 13, 2022.